Provider Demographics
NPI:1518481548
Name:DEVDAS, NEETHA (PHD)
Entity Type:Individual
Prefix:DR
First Name:NEETHA
Middle Name:
Last Name:DEVDAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7202 ARCHES AVE
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-3556
Mailing Address - Country:US
Mailing Address - Phone:469-371-3462
Mailing Address - Fax:
Practice Address - Street 1:1205 S WHITE CHAPEL BLVD STE 280
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-9330
Practice Address - Country:US
Practice Address - Phone:682-651-8651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36107103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling